History of occupational health

Global Perspective:The first book on occupational medicine, De Morbis Artificum Diatriba (meaning “Diseases of Workmen”), was published in 1700 in Italy by the “father of occupational medicine” Bernardino Ramazzini (1633-1714). It contained accurate descriptions of occupational diseases linked to various types of jobs.

Then came the Industrial Revolution in England (1760-1830), which gave pace to the occupational health movement. Dr. Alice Hamilton played a great role in the development of industrial hygiene in America during the early part of the 20th century. The Office of Industrial Hygiene and Sanitation was established in 1914 in the USA. In 1919, the ILO came into being in Geneva, Switzerland, with a Department of Occupational Safety, Health and Welfare. Subsequently, the WHO in Geneva, Switzerland, also set up a Department of Occupational Medicine.

Indian Perspective:The first Factories Act was passed in 1881 in British India. The act was amended in 1891, 1911, 1923, 1934 and 1948 to bring the legislation in line with that of the British Factory Act. The Bhopal Gas tragedy (1984) was a turning point towards legislation pertaining to occupational health and safety in India. The Factories Act was amended (1987) and stipulated the qualifications/strength of occupational health staff in hazardous industries. At present 29 diseases have been included as “notifiable” occupational diseases under this Act.

There is a dearth of qualified occupational health physicians in our country. Awareness about occupational health is at a low level even in the organised sector. Most affected is the unorganised and small-scale sector. The Indian Association of Occupational Health is the leading NGO in the field of occupational health in India.

Occupational health

“Occupational health should aim at the promotion and maintenance of the highest degree of physical, mantal and social wellbeing of the workers in all occupations; the prevention among workers of departures from health caused by there working conditions; the protection of workers in their employement from risks resulting from factors adverse to health; the placing and maintenance of the workers in an occupational environment adapted to his physiological and psychological equipment, and, to summarize, the adaptation of work to man and of each man to his job”

(JOINT ILO & WHO SESSION IN 1950)

Health of the worker

The factors that influence the health of the population also apply equally to the industrial workers, i:e biological, behavioral, environmental, socioeconomic, health system, sociocultural, aging of population, science and technology, information and communication, gender, equity, social justice and human rights ( determinants of health ). in addition to these factors the health of the workers is also influenced by conditions prevailing in the work place. (i:e occupational environment)

Occupational environment

Occupational environment can be defined as the sum of external conditions and influences which prevail at the work place and which has bearing on the health of the working population. Basically there are three type of interaction in a working environment

a) Man and physical, chemical biologicalb) Man and machinec) Man and man

Man and physical, chemical, biological

a) Physical agents

The physical factors in the working environment which may be adverse to health are heat, cold, humidity, air movement, heat radiation, light, noise, vibrations and ionizing radiations. The amount of working and breathing space, toilet, washing and bathing facilities are also important factors in an occupational environment.

b) Chemical agents These comprises a large number of chemicals, toxic dust and gases which are potential hazard to the health of the workers

c) Biological agentsd) The workers may also get exposed TO viral bacterial, ricketcial and paracitic agents which may result

from close contact with animals or their products, contaminated water, soil or food. Man and machine

An industry or factory implies the use of machines, driven by power with emphasis on mass production. The unguarded machines, protruding and moving parts, poor installation of the plant, lack of safety measures are the causes of accidents which is a major problem in industries.

Man and man

There are numerous psychosocial factors which operate at the place of work. These are the human relationships that exist among the workers and also between the workers and the their superiors. The many psychosocial factors which influence the workers are work rhythm and stability, service condition, job satisfaction, leadership style security,workers participation , communication, system of payment, welfare conditions, degree of responsibilities, trade union acitivities, incentieves etc. the occupational health of the worker is also affected by his domestic environment.

Occupational hazard

There are five type of hazard that an industrial worker may be exposed to.1) Physical hazard2) Chemical hazard3) Biological hazard 4) Mechanical hazard

5) Psychological hazard

Physical hazarda) Heat and cold

The direct effect of heat exposure are burns, heat exhaustion, heat stroke, and heat cramps, the indirect effect are decreased efficiency, increased fatigue, and enhanced accident rates. Many industries have local hot spots oven and furnaces which radiates heat. radiant heat is the main problem in foundry, glass and steel industries. While heat stagnation is the principal problem in jute and cotton textile industry. Indian factories act have not laid down any specific temperature standard, but work of rao and mookerjee (1953) indicate that a temperature of 20 to 27 °c is the comfort zone in the country and the tempratur above it causes discomfort. Apart from these hazards accosiated with cold are chilblains, erythrocynosis, immersion foot and frostbite.

b) Light

The workers may be exposed to poor illumination or excessive light, the hazards of poor illumination are eye strain, headache, eye pain, lachrymation, congestion around the cornea eye fatigue, and miners nystagmus. Exposure to intense light may lead to visual fatigue, annoyance and discomfort. It may also lead to blurring vision and may lead to accidents.

c) Noise

Noise is a health hazard in many industries. There are two type of auditory hazards these are 1) auditory effects such as temporary or permanent hearing loss and 2) non auditory effects such as nervousness, fatigue, interference with communication by speech. Decreased efficiency and annoyance

d) Vibration

Vibrations especially in the frequency of 10 to 500 hz may be encountered in work with pneumatic tools such as drills and hammers. Vibrations usually affects the hands and arms. After a prolonged period of exposure the worker may experience white finger(fingers may become increasingly sensitive to spasm), injuries to to joints of hands, elbows and shoulders.

e) Ultraviolet radiationWelders are commonly affected by this kind of radiation (welder’s flash), the results are conjunctivitis and keratitis

f) Ionizing radiation

Medicine and others industries are at risk of exposure to ionizing radiation, x-rays and radioactive isotopes play a major role, important radio isotopes are cobalt 60 & phosphorous 32, bone marrows and gonads are the tissues which are affected by such kind of radiation. The hards may include, genetic changes, cancer, leukemia, depilation, ulceration, sterility and in extreme cases death. The maximum permissible radiation is 5 rem /year to the whole body.

Chemical hazards

The chemical hazards which occur in the industries occur by three ways local action, inhalation and ingestion

1. Local action : the local action are dermatitis, eczema, and ulcers some even cause cancers, some chemicals particularly the aromatic nitro and amino compounds such as TNT and analine are absorbed through the skin and causes systemic effects

2. Inhalation :-

Dusts :-dusts are finely divided solid particles with size ranging from 0.1 to 150 microns those that are greater than 10 microns settle down faser and those that are less than 10 micron remain suspended in the air and those that are less than 5 microns are directly absorbed into the lungs and is a cause of pneumoconiosis the dust may be classified as organic, inorganic, soluble and insoluble, organic dusts are from cotton jute etc and inorganic is from coal, mica etc. soluble are those that are absorbed in to the systemic circulation and excreted from the body and insoluble are those that are absorbed into the lungs and are unable to get eliminated and are the main causes of pneumoconiosis

Gases:- exposure to gases is a common hazard in industries, gases may be classified as simplegases (oxygen, hydrogen) , asphyxiating gases (carbon mono oxide, cyanide gas) and anesthetic gases ( chloroform, ether, trichloroethelene).

Metals and other compounds:- a large number of metals are and their compounds are used throughout the industries. the chief mode of entry of some of them is through inhalation. The adverse effect of these depend on the duration of exposure and also the dose or concentration of exposure. The metals that have adverse effect are lead, mercury, antimony, zinc, chromium, cadmium etc

3. Ingestion :-

Occupational disease may also result from the ingestion of chemical substances, usually the ingestion takes place through contaminated hands and cigarettes but large amount are excreted through the feces and only a small amount is absorbed into the systemic circulation.

Biological hazard

Workers may be exposed to infective and parasitic agents at the place of work. The occupational disease in this category are brucellocis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus, encephalitis, fungal infection, schistomosis and a host of others. Persons working among animal products and agricultural workers are exposed to biological hazard

Mechanical hazard

The mechanical hazard are due to protruding and moving parts about 10 percent of the accidents in industries are said to be due to mechanical causes

Psychosocial hazards

The psychosocial hazards arise from workers adaptation to new environment. Frustration , lack of job satisfaction, poor human relationships, emotional tension are some of the psychosocial factors which undermines the efficiency of the health and efficiency of the workers. The psychosocial hazards can be manifested in the form of psychological and behavioual changes such as hostility, aggressiveness, anxiety,

depression, tardiness, alchoholism, drug abuse, absenteeism and psychosomatic ill health such as fatigue, headache, pain in the shoulders,neck and back, propensity to peptic ulcers hypertension, heart disease and rapid aging.

Ergonomics

Definition : Ergonomics, also known as human factors, is the scientific discipline that seeks to understand and improve human interactions with products, equipment, environments and systems. Drawing upon human biology, psychology, engineering and design, ergonomics aims to develop and apply knowledge and techniques to optimise system performance, whilst protecting the health, safety and well-being of individuals involved. The attention of ergonomics extends across work, leisure and other aspects of our daily lives

It may also be defined as fitting the job to the worker. The application of ergonomics has contributed to the reduction in accidents and overall achievement of health and efficiency of the workers.

MEASURES FOR HEALTH PROTECTION OF WORKERS

The joint committee of ILO/WHO has recommended following heath protection for workers

1. NUTRITION

In many countries malnutrition of workers is a major problem. The malnourishment among workers causes poor health and low work outout, it may also affect the metabolism of toxic agents and also the tolerance mechanisms. Inorder to avoid this problem the Indian factories act has provided a provision to provide canteen for the workers where the number of the workers exceed 250, where a balanced diet will be provided and food will be served under sanitary conditions. Apart from these if a worker brings his tiffin from home arrangements should be made to have his food in a room other than the work room under sanitary conditions.

2. COMMUNICABLE DISEASE CONTROL

The industry provides an excellent opportunity for the diagnosis, treatment, prevention and rehabilitation of many diseases prevalent among the workers. It is a general objective of the industries to detect the communicable disease among the workers and prevent or treat it so as to render it non infectious to others. The communicable disease of special interest in india are TB, malaria, intestinal parasites, hepatitis, amoebiasis. Immunization programmes are also available in industries

3. ENVIRONMENTAL SANITATIONUnder environmental sanitation following factors are considered

a) Water supplySufficient amount of wholesome water supply is a basic requirement of all industries, the old way of water tumblers should be avoided as it spreads infection. Water fountains at different points should be established

b) Food Education about safe and hygienic way of preparation, handling and storage of food should be given to the food handlers inorder to avoid the outbreak of gastro- intestinal diseases

c) Toilet

There should be sufficient number of toilets for the male and female workers sepeately. According to the norm there should be 1 toilet for every 25 workers (separate for males and females) till 100 workers and then 1 tolit for every 50 workers thereafter. Garbage disposal system should be such as to prevent breeding of flies and vermin.

d) General plant cleanlinessThe walls cellings and passages should be adequately painted with water washable paints and repainted atleast every 3 years and washed every 6 months. Dust which gets settled after the wok should be promptly cleaned with wet cloths and vacuum cleaners.

e) Sufficient spaceSufficient floor space and cubic space are essential not only to prevent respiratory infection but also to ensure a comfortable working environment. The recommended atandard is a 500cu.ft of space for every worker.

f) LightingThere should be sufficient amount of light at the place where the workers work and also where the workers pass by. The standards are 50-75 foot candles for the job requiring high degree of accuracy, 6 to 12 foot candles may be sufficient for place where people work regularly and 0.5 foot candles for the corridors

g) Ventilation, temperaturePoor ventilation not only brings respiratory diseases but also affects the mental and physical efficiency of the workers. Effective and suitable provision should be made for the proper exit of noxious fumes and gases and provisions should be made such that fresh air is circulated in all room where the workers are working. Adequate temperature at the work place is also recommended.

h) Protection against hazard There should be a adequate measures for protection of workers against dust, fumes and toxic hazards.

4. MENTAL HEALTHThe objective of occupational health service is not only to keep the workers physically fit and healthy but also mentally and psychologically stable. The goals of mental health in industries are

1) Promote the health and happiness of the workers2) To detect signs of emotional stress and strain and to secure relief of stress and strain

where possible.3) The treatment of employees suffering from mental illness4) Rehabilitation of those who become ill.

5. MEASURES FOR WOMEN AND CHILDRENWomen are susceptible to many health hazards than men and also pregnant women can face many problems as the hazards at the work place may threaten the development of the growing fetus. Following protective measures are available for women workers in india.

a) Expectant mothers are given maternity leave for 12 weeks, of which the 6 weeks precede the expected maternity benefit, which is a cash benefit under the ESI act 1948.

b) Provision of free antenatal, natal and postnatal servicesc) The factories act prohibit night work between 7pm and 6 am. And also prohibits carrying

of excessive weight beyond a certain schedule which has been laid down.d) The Indian mines act prohibits work undergrounde) The factories act provide crèches facilities where more than 30 women are employed

and also prohibits employment of certain women and children in certain dangerous occupations

f) The constitution of india dosen’t allow any children below 14 years of age to work in any factories or hazardous environment.

6. HEALTH EDUCATIONHealth education is a basic health need and should be provided to the various levels such as managerial, supervisory, trade union, workers etc according to their needs

7. FAMILY PLANNINGFamily planning is a decisive factor for the quality of life and this applies to industrial workers also. Workers must adopt small family norm.

PREVENTION OF OCCUPATIONAL DISEASES

The various measures of prevention of occupational disease may be grouped under three headings as medical, engineering and statutory or legislative

1. Medicala) Preplacement examination

Preplacement examination as the name suggest is done before the placement of the workers, it comprises of workers through medical, family, occupational and social history. It consist of through physical examination and also an array of biological and radio examination like x ray, ECG, blood and urine test etc. the main aim of the preplacement examination is to place the right person in the right job.

b) Periodical examinationMany occupational diseases require a months or even years to develop. The slow development will often leads non recognition in the early stages and this is harmful for the workers and so periodic medical examination becomes necessary. The frequency of medical examination depends on the type of occupational exposure, ordianarily the workers are examined once a year but in certain occupational exposure monthly or even daily examination is required.

c) Medical and health care servicesMedical and health care service is a notable function of occupational health. In india employee state insurance corporation provides medical benefit to not only the worker but also his family. The first aid to the worker at the work place and immunization is also an important function

d) Notification

National laws and regulation require the notification of cases and suspected of cases of occupational diseases. The prime aim of notification is to initiate measures for prevention and protection and ensuring their effective application. And to investigate the working conditions and other circumstances which have caused or suspected to have caused occupational diseases. In the factories act a list of 22 diseases is included while in mines act 3 diseases and in dock regulations 8 diseases are involved for which the the workers may receive compensation.

e) Supervision of working environmentPeriodic inspection to the working environment provides physician with sufficient data to prevent occupational diabilities. The physician should visit the occupational environment and look after the working environment such as the temperature, ventilation, lighting etc. he should also study the products such as the raw materials used and its effect on the workers in the due course of processing, handling and dispensing. After collecting sufficient data the physician should notify the authority concerned to make improvement in the occupational health of the workers.

f) Maintenance and analysis of recordsproper maintenance of records are essential for the formulation, planning and operation of occupational health in industries. The workers health record and disability record should be maintained strictly

g) Health education and counselingThe process of health education should begin before the worker enters the occupation, he should be made aware about the situation he is going to handle and the threats he is going to face in the occupation, as soon as he enters the job the workers should be instructed regarding the personal safety and hygienic measures that he should ensue inorder to have a health occupational and social life. Apart from these he must also be reminded with the help of media about the hazards he could face during the occupation if or otherwise he dosent take safety measures

2. Engineering measuresa) Design of building

Measures for the prevention of occupational diseases should commence in the blueprint stage. The type of roof, celing, doors and cubic space are all matters which should recieve attention during the plan because once the building is constructed it is difficult to bring about the change.

b) Good house keepingGood housekeeping is a term often applied to industries and means much the same as when used domestically. It covers general cleanliness, washing, ventilation, lighting, washing, food arrangements and general maintenance good housekeeping is a fundamental requirement for the control or elimination of the occupational hazard. The walls, ceilings and passages should be white washed once a year. The dust which settles down on thefloor, ledges, beams, machinery should be promptly cleaned. Not only inside but also outside of the building must be kept clean.

c) General ventilation

There should be a good general ventilation in factories, the recommendation is to provide a ventilation opening of 5sqft for each worker in a working room and where abundant amount of dust is generated an exhaust ventilation is recommended. The Indian factories act has prescribed a air space of 500cu.ft for each worker.

d) MechanizationMechanization is recommended completely as much as in the plant as possible, this will reduce the human contact with the harmful chemicals and thus hazards can be reduced to much extent. For example if hand mixing is replaced by machines contact dermatitis can be prevented. Acids and other chemicals can be conveyed from one place to others through pipes.

e) SubstitutionSubstitution means replacement of harmful chemical by the less harmful one. For example the white phosphorous in the match industry is replaced by phosphorous sesquisulphide which has reduced the necrosis of jaw (phossy jaw) to much extent. zinc and iron paints can be used instead of harmful lead paints.

f) DustsDusts can be controlled at the point of origin by the water sprays.eg: wet drilling of rocks, inclusion of little moisture in the materials will make the process of grinding, sieving and mixing comparatively dust free.

g) Enclosure Enclosing the harmful material and processes will prevent the escape of dust into the factory atmosphere. For example grinding machinery can be completely enclosed. Such enclosed units are generally combined with exhaust ventilation

h) Isolation Sometimes some process of the industry can be done in isolation so that the workers who are not in direct contact with the process can be protected from the hazard. The isolation is not only done in space but also in the time, as some process are carried out in night hours so that the workers are not affected

i) Local exhaust ventilationLocal exhaust ventilation traps the dusts , fumes and noxious gases at the point of origin and makes the breathing environment clean for the workers. In this process the hood of the ventilator is placed at the source of origin of dust and dust is sucked up into the hood through suction method and is collected into the collector thus making the breathing environment clean for the workers

j) Protective devicesThe workers use many protective devices such as respirators, gumboots, gloves, goggles, protective creams etc. respirators are one of the oldest method for protection. Respirators are of two types that is one which filter the harmful material and one to which fresh air is supplied.the workers should know when to use and how to use the respirator devices, respirators should not be substituted with other control measures

k) Environmental monitoring

An important aspect of occupational health is environmental monitoring. it is concerned with periodical environmental surveys especially the factory atmosphere to determine whether the dust and gases escaping into the atmosphere is under permissible level or not.

l) Statistical monitoring Statistical monitoring comprises review at regular intervals of collected data on health and environmental exposure of occupational groups. The main objective of these review is to evaluate the adequacy of preventive measures and occupational health criteria , including permissible exposure

m) Research Research in occupational health provides a fertile ground for study which can provide a better understanding of the industrial health problems. There are two kind of research, pure research and research for the improvement of, or in connection with a manufactured product. Both are important from the occupational health point of view

3. Legislation Society has obligation towards the workers, society has claimed the worker to be more important than the machine that he runs therefore society has come forward with certain laws and benefit in favor of the workers. There are many acts and laws which are prominent among which the

1) THE FACTORIES ACT 1948The first Indian factories act dates as far back as 1881. The act was revised and amended several times. The latest amendment was done in 1987. Description of the act is as follows

a) Scope The act defines factory as an establishment with 10 or more workers without power and

20 or more workers with power There is no distinction between seasonal and perennial factories The applies to all the country except to the state of Jammu and Kashmir

b) Health safety and welfare

Elaborate provisions have made for the health safety and welfare of the workers

The act provides for the treatment of waste and effluents so as to render them innoccous, and for their disposal, the elimination of dust and fumes, provision of spittoons, control of temperature, supply of cool drinking water during summer and for the employment of cleaners to keep the water closets clean.

A minimum of 500 cu ft of space for each worker has been prescribed For factories installed before 1948act a minimum of 350 cu ft of space has been prescribed Many safety provisions related to casing of machinery, cranes, hoists and lifts, protection of eyes

and precaution against dangerous fumes, explosives and inflammable materials. The act requires that no worker shall be required to lift or carry loads which are likely to cause

him injury.

The 1976 ammendment provides for the appointment of safety officers in every factory wherein 1000 or more workers are ordinarily employed.

The act contains a separate chapter for the welfare of the workers eg: washing facilities, facilities for storing and drying clothes, facilities for sitting, first aid appliances, shelters and rest rooms , canteens and crèches. The act specifies that wherein more than 250 employees are employed a canteen shall be provided. The 1976 amendment provides for crèches in every factory wherein more than 30 women workers are ordinarily employed.

In every factory wherein more than 500 workers are employed a welfare officer should be employed

c) Employment of young persons The act prohibits the working of children below 14 years of age Those between the age group of 15 to 18 years are called as adolescents and they should be

certified by surgeons and physicians to be medically fit for doing the job Adolescent employee is allowed to work only from 6am to 7pm Women and children are restricted to do certain jod which may prove them hazardousd) Hours of work

The act has prescribed 48 hours of work per week with not more than 9 hours per day and half an hour rest after a continuous work of 5 hours

The adolescents are allowed to work only four and hours per day The total number of hours in a week should not exceed 60 along with overtime

e) Leave with wages

The act has provision for leaves that after one year of continous service in an institution the worker is eligible for leave as under ( the leave that are mentioned below are leave apart from weekly holidays)

An adult worker is permitted to take one leave for every 20 days of work and the leave can be accumulated up to 30 days.

An adolescent worker is allowed to take a leave for every 15 days and the leave can be gathered for 40 days.

f) Occupational diseases It is obligatory on the part of factory management to inform the workers regarding the accidents

that can cause death, serious bodily injuries, and diseases contracted by the workers. The act has certain scheduled diseases like asbestosis, bysinosis, occupational dermatitis and

noise induced hearing loss. Provision has also been made for the occupational health and safety surveys in factories and

industries.g) Employment in hazardous process

The central government has incorporated a new chapter iv A by factories amendment act 1987, relating to hazardous processes. Site appraisal committee consisting of chief inspector and other members not more than 14 in number for examination of service condition in a factory involving hazardous processes is to be constituted for recommendations

2) EMPLOYEES’ STATE INSURANCE ACT 1948

The ESI act passed in 1948 is an important measure of social security and health insurance in the country it provides for certain cash and medical benefits for the employees in case of sickness, maternity and employment injury

a) Scope

the act extends to the whole of india. The ESI act of 1948 covered all the power using factories other than the seasonal factories wherein 20 or more persons were employed (excluding mines, railways and defense establishments). The provision of ESI act of 1975 were extended to the following new class of establishments

a. Small power using factories employing 10 to 19 persons and non power using factories employing 20 or more persons

b. Shopsc. Hotels and restaurantsd. Cinemas and theaterse. Road motor transport establishmentsf. News paper establishments

b) Administration

The administration of ESI scheme under the act is entrusted to an autonomous body called the ESI corporation. The union minister for the labor is the chairman and the secretary to government of india, ministry of labor is the vice chairman of this cooperation. It consist of members representing, central and state governments, employers and employees organizations, medical proffesion and parliament. There is a standing committee constituted from the members of the cooperation, which act as an executive body for the administration of the scheme. The chief executive officer is the director general who is assisted by four principal officers. I:e insurance commissioner, medical commissioner, financial commissioner, and actuary. There is a medical benefit council which is headed by the director general of health services, government of india who is assisted by medical commissioner in all matters relating to medical relief.

c) Finance The scheme is run by contributions from the employers and employees and grants from central and state governments

d) Benefits to employeesThe act has made following benefits

a) Medical benefitsMedical benefit consist of full medical care including hospitalization free of coast to the insured persons in case of sickness, employment injury and maternity. The service comprises

Out patient care Supply of drugs and dressings Specialist services in all branches of medicine Pathological and radiological investigations Domiciliary services Antenatal and post natal services Immunization services Family planning services

Emergency services Ambulance services Health education Inpatient treatment

b) Sickness benefits

It consist of periodical cash payment to an insured person in case of sickness, if his sickness is duly certified by an insurance medical officer. The benefit is payable for maximum period of 91 days in any continuous period of 365 days. The daily rate being about 50% of the average daily wages. A person receiving the sickness benefit is required to remain under medical treatment provided under the act. In addition to 91 days of sickness benefit, insured person suffering from certain long term diseases are entitled to extend sickness benefit

c) Maternity benefit

The benefit is payable in cash to an insured women for confinement / miscarriage or sickness arising out of pregnancy/ confinement or premature birth of child or miscarriage. For confinement the duration of benefit is 12 weeks, for miscarriage 6 weeks and for sickness arising out of confinement 30 days. The benefit is allowed at about full wages.

d) Disablement benefits

The act provides for cash payment, besides free medical treatment, in the event of temporary or permanent disablement as a result of employment injury as well as occupational diseases. The rate of temporary disablement benefit is about 70 % of the wages as long as the temporary disablement lasts. In case of total permanent disablement, the insured person is given life pension worked out on the basis of earning capacity determined by a medical board, while in case of partial permanent disablement a portion of it is granted as life pension.

e) Dependent benefits

In case of death of an insured person while in an occupation the dependent of the insured person shall receive the dependent benefits. The benefit will be 70 percent of the wages every month in the name of dependent. If an eligible son or daughter is the dependent then the benefits could be received by them till the age of 18

f) Funaral expenses

In case of death of an insured person the scheme provides for the funeral of the not more than rs.2500

g) Rehabilitation allowance

On monthly payement of rs. 10 the insured person and his family members continue to get medical treatment after permanent disablement or retirement.

Legal permission to start factory

Following are the legal requirements to start a factory

Make a plan for factory with map and get it approved from factories dept and take licence

Take SSI certificate and polution NOc ESI and PF codes are also regd. Prepare standing orders and get them certified from DLC Take fire NOC Take air and wter consent from polution dept. Take sale tax number Permission from Explosive Dept.( If storing of HSD) PAN No. TIN No. Certificate of Labour employing by Labour Dept.( It's for once time) Building Permission from Local Panchayat(Lay out approal) License from Local Panchayat NOC from Local Panchayat Police Clearance Permission to take from Electrical Dept. for advance to applying Electrical

connection Agriculture Land should be convert to Non Agriculture from DC concerned District

Occupational safety and health(OSH) management system.

The protection of workers against work-related sickness, disease and injury forms part of the historical mandate of the ILO. Disease and injury do not go with the job nor can poverty justify disregard for workers' safety and health. The ILO's primary goal is to promote opportunities for women and men to obtain decent and productive work in conditions of freedom, equity, security and human dignity. We have summarized this as "decent work". Decent work is safe work. And safe work is also a positive factor for productivity and economic growth.

Taking these factors into consideration the ILO has developed occupational safety and health management systems

Elements of ocuupational safety and health management systems

A. Policy B. OrganizingC. Planning and implementationD. EvaluationE. Action for improvementF.

A. Policy The employer, in consultation with workers and their representatives,

should set out in writing an OSH policy

The OSH policy should include, as a minimum, the following keyprinciples and objectives to which the organization is committed:(a) protecting the safety and health of all members of the organization by preventing

CONTINOUS IMPROVRMENT

Policy

Organizing

Evaluation

Planning

&

implimentation

Action for

improvement

work-related injuries, ill health, diseases and incidents;(b) complying with relevant OSH national laws and regulations, voluntaryprogrammes, collective agreements on OSH and other requirements to which theorganization subscribes;(c) ensuring that workers and their representatives are consulted and encouraged toparticipate actively in all elements of the OSH management system; and(d) continually improving the performance of the OSH management system.

The OSH management system should be compatible with or integrated inother management systems in the organization.

Worker participation is an essential element of the OSH managementsystem in the organization.

The employer should ensure that workers and their safety and healthrepresentatives are consulted, informed and trained on all aspects of OSH, including emergency arrangements, associated with their work.

The employer should make arrangements for workers and their safety andhealth representatives to have the time and resources to participate actively in the processes of organizing, planning and implementation, evaluation and action for improvement of the OSH management system.

The employer should ensure, as appropriate, the establishment andefficient functioning of a safety and health committee and the recognition of workers'safety and health representatives, in accordance with national laws and practice.

B. ORGANIZING The employer should have overall responsibility for the protection of

workers' safety and health, and provide leadership for OSH activities in the organization.

The employer and senior management should allocate responsibility,accountability and authority for the development, implementation and performance of the OSH management system and the achievement of the relevant OSH objectives.

A person or persons at the senior management level should be appointed, where appropriate, with responsibility, accountability and authority

The necessary OSH competence requirements should be defined by theemployer, and arrangements established and maintained to ensure that all persons are competent to carry out the safety and health aspects of their duties and responsibilities.

The employer should have, or should have access to, sufficient OSHcompetence to identify and eliminate or control work-related hazards and risks, and to implement the OSH management system.

Training should be provided to all participants at no cost and should takeplace during working hours, if possible.

OSH records should be established, managed and maintained locally andaccording to the needs of the organization. They should be identifiable and traceable,and their retention times should be specified.

Workers should have the right to access records relevant to their working

environment and health, while respecting the need for confidentiality.C. PLANNING AND IMPLIMENTATION

The organization's existing OSH management system and relevantarrangements should be evaluated by an initial review, as appropriate. In the case whereno OSH management system exists, or if the organization is newly established, the initial review should serve as a basis for establishing an OSH management system.

The initial review should be carried out by competent persons, inconsultation with workers and/or their representatives, as appropriate.

Arrangements should be made for adequate and appropriate OSH planning,based on the results of the initial review, subsequent reviews or other available data.These planning arrangements should contribute to the protection of safety and health at work

The OSH planning arrangements of the organization should cover thedevelopment and implementation of all the OSH management system elements,

Consistent with the OSH policy and based on the initial or subsequentreviews, measurable OSH objectives should be established,

. Hazards and risks to workers' safety and health should be identified andassessed on an ongoing basis. Preventive and protective measures should beimplemented

The impact on OSH of internal changes (such as those in staffing or dueto new processes, working procedures, organizational structures or acquisitions) and of external changes (for example, as a result of amendments of national laws and regulations, organizational mergers, and developments in OSH knowledge and technology) should be evaluated and appropriate preventive steps taken prior to the introduction of changes.

A workplace hazard identification and risk assessment should be carriedout before any modification or introduction of new work methods, materials, processes or machinery. Such assessment should be done in consultation with and involving workers and their representatives, and the safety and health committee, where appropriate.

The implementation of a "decision to change" should ensure that all affected members of the organization are properly informed and trained.

Emergency prevention, preparedness and response arrangements shouldbe established and maintained. These arrangements should identify the potential for accidents and emergency situations, and address the prevention of OSH risks associated with them. The arrangements should be made according to the size and nature of activity of the organization.

Emergency prevention, preparedness and response arrangements shouldbe established in cooperation with external emergency services and other bodies where applicable.

Arrangements should be established and maintained for ensuring that theorganization's safety and health requirements, or at least the equivalent, are applied to contractors and their workers

.D. EVALUATION

Procedures to monitor, measure and record OSH performance on a regular

basis should be developed, established and periodically reviewed. Responsibility,accountability and authority for monitoring at different levels in the managementstructure should be allocated.

The selection of performance indicators should be according to the size and nature of activity of the organization and the OSH objectives

Both qualitative and quantitative measures appropriate to the needs of theorganization should be considered.

The investigation of the origin and underlying causes of work-related injuries, ill health, diseases and incidents should identify any failures in the OSH management system and should be documented.

Such investigations should be carried out by competent persons, with the appropriate participation of workers and their representatives.

The results of such investigations should be communicated to the safety and health committee, where it exists, and the committee should make appropriate recommendations.

The results of investigations, in addition to any recommendations from thesafety and health committee, should be communicated to appropriate persons forcorrective action, included in the management review and considered for continualimprovement activities.

The corrective action resulting from such investigations should beimplemented in order to avoid repetition of work-related injuries, ill health, diseases and incidents.

Reports produced by external investigative agencies, such as inspectoratesand social insurance institutions, should be acted upon in the same manner as internal investigations, taking into account issues of confidentiality.

Arrangements to conduct periodic audits are to be established in order todetermine whether the OSH management system and its elements are in place, adequate, and effective in protecting the safety and health of workers and preventing incidents.

An audit policy and programme should be developed, which includes adesignation of auditor competency, the audit scope, the frequency of audits, auditmethodology and reporting.

The audit includes an evaluation of the organization's OSH managementsystem elements or a subset of these, as appropriate.

Audits should be conducted by competent persons internal or external tothe organization who are independent of the activity being audited.

The audit results and audit conclusions should be communicated to thoseresponsible for corrective action.

Consultation on selection of the auditor and all stages of the workplaceaudit, including analysis of results, are subject to worker participation, as appropriate.

E. ACTION FOR IMPROVEMENT Arrangements should be established and maintained for preventive and

corrective action resulting from OSH management system performance monitoring and measurement, OSH management system audits and management reviews.

When the evaluation of the OSH management system or other sourcesshow that preventive and protective measures for hazards and risks are inadequate or likely to become inadequate, the measures should be addressed according to therecognized hierarchy of prevention and control measures, and completed and documented, as appropriate and in a timely manner.

The safety and health processes and performance of the organizationshould be compared with others in order to improve health and safety performance.

AN EXAMPLE OF OCCUPATIONAL HAZARD

The great Bhopal gas tragedy

Introduction

The Bhopal disaster was the world's worst industrial catastrophe. It occurred on the night of December 2–3, 1984 at the Union Carbide India Limited (UCIL) pesticide plant in Bhopal, Madhya Pradesh, India. A leak of methyl isocyanate gas and other chemicals from the plant resulted in the exposure of hundreds of thousands of people. Estimates vary on the death toll. The official immediate death toll was 2,259 and the government of Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release.[1] Other government agencies estimate 15,000 deaths.[2] Others estimate that 3,000 died within weeks and that another 8,000 have since died from gas-related diseases.[3][4] A government affidavit in 2006 stated the leak caused 558,125 injuries including 38,478 temporary partial and approximately 3,900 severely and permanently disabling injuries.[5]

The cause of tragedy

It emerged in 1998, during civil action suits in India, that the plant was not prepared for problems. No action plans had been established to cope with incidents of this magnitude. This included not informing local authorities of the quantities or dangers of chemicals used and manufactured at Bhopal.[3][4][13][20]

The MIC tank alarms had not worked for four years.[3][4][13][25] There was only one manual back-up system, compared to a four-stage system used in the US.[3][4][13][25] The flare tower and the vent gas scrubber had been out of service for five months before the disaster.

The gas scrubber therefore did not treat escaping gases with sodium hydroxide (caustic soda), which might have brought the concentration down to a safe level.[25] The maximum pressure the scrubber could handle, provided it had been operating, was only a quarter of the pressure during the leak. The flare tower could only hold a quarter of the gas that leaked in 1984.[3][4][13][26]

To reduce energy costs, the refrigeration system was idle. The MIC was kept at 20 degrees Celsius, not the 4.5 degrees advised by the manual. [3][4][13][25]

The steam boiler, intended to clean the pipes, was out of action for unknown reasons.[3][4][13][25] Slip-blind plates that would have prevented water from pipes being cleaned from leaking into the MIC

tanks through faulty valves were not installed. Their installation had been omitted from the cleaning checklist.[3][4][13]

The water pressure was too weak to spray the escaping gases from the stack. They could not spray high enough to reduce the concentration of escaping gas.[3][4][13][25]

According to the operators the MIC tank pressure gauge had been malfunctioning for roughly a week. Other tanks were used rather than repairing the gauge. The build-up in temperature and pressure is

believed to have affected the magnitude of the gas release.[3][4][13][25] UCC investigation studies have disputed this hypothesis.

Carbon steel valves were used at the factory, even though they corrode when exposed to acid.[20] UCC admitted in their own investigation report that most of the safety systems were not functioning on

the night of December 3, 1984.[17] The design of the MIC plant, following government guidelines, was "Indianized" by UCIL engineers to

maximize the use of indigenous materials and products. Mumbai based Humphreys and Glasgow Consultants PVT. Ltd. were the main consultants, Larsen and Toubro fabricated the MIC storage tanks, and Taylor of India Ltd. provided the instrumentation. [27]

previous warnings

A series of prior warnings and MIC-related accidents had occurred:

In 1976, the two trade unions reacted because of pollution within the plant.[4][21] In 1981, a worker was splashed with phosgene. In panic he ripped off his mask, thus inhaling a large

amount of phosgene gas; he died 72 hours later.[4][21] In January 1982, there was a phosgene leak, when 24 workers were exposed and had to be admitted to

hospital. None of the workers had been ordered to wear protective masks. In February 1982, an MIC leak affected 18 workers.[4][21] In August 1982, a chemical engineer came into contact with liquid MIC, resulting in burns over 30

percent of his body.[4][21] In October 1982, there was a leak of MIC, methylcarbaryl chloride, chloroform and hydrochloric acid.

In attempting to stop the leak, the MIC supervisor suffered intensive chemical burns and two other workers were severely exposed to the gases.[4][21]

During 1983 and 1984, leaks of the following substances regularly took place in the MIC plant: MIC, chlorine, monomethylamine, phosgene, and carbon tetrachloride, sometimes in combination.[4][21]

Reports issued months before the incident by UCC engineers warned of the possibility of an accident almost identical to that which occurred in Bhopal. The reports never reached UCC's senior management.[4][20]

UCC was warned by American experts who visited the plant after 1981 of the potential of a "runaway reaction" in the MIC storage tank. Local Indian authorities warned the company of problems on several occasions from 1979 onwards. [4][20]

short term health effects

The leakage caused many short term health effects in the surrounding areas. Apart from MIC, the gas cloud may have contained phosgene, hydrogen cyanide, carbon monoxide, hydrogen chloride, oxides of nitrogen, monomethyl amine (MMA) and carbon dioxide, either produced in the storage tank or in the atmosphere.[4]

The gas cloud was composed mainly of materials denser than the surrounding air, stayed close to the ground and spread outwards through the surrounding community. The initial effects of exposure were coughing, vomiting, severe eye irritation and a feeling of suffocation. People awakened by these symptoms fled away from the plant. Those who ran inhaled more than those who had a vehicle to ride. Owing to their height, children and other people of shorter stature inhaled higher concentrations. Many people were trampled trying to escape.[4]

Thousands of people had succumbed by the morning hours. There were mass funerals and mass cremations as well as disposal of bodies in the Narmada river. 170,000 people were treated at hospitals and temporary dispensaries. 2,000 buffalo, goats, and other animals were collected and buried. Within a few days, leaves on trees yellowed and fell off. Supplies, including food, became scarce owing to suppliers' safety fears. Fishing was prohibited as well, which caused further supply shortages.[4]

A total of 36 wards were marked by the authorities as being "gas affected", affecting a population of 520,000. Of these, 200,000 were below 15 years of age, and 3,000 were pregnant women. In 1991, 3,928 deaths had been certified. Independent organizations recorded 8,000 dead in the first days. Other estimations vary between 10,000 and 30,000. Another 100,000 to 200,000 people are estimated to have permanent injuries of different degrees.[4]

The acute symptoms were burning in the respiratory tract and eyes, blepharospasm, breathlessness, stomach pains and vomiting. The causes of deaths were choking, reflexogenic circulatory collapse and pulmonary oedema. Findings during autopsies revealed changes not only in the lungs but also cerebral oedema, tubular necrosis of the kidneys, fatty degeneration of the liver and necrotising enteritis.[28] The stillbirth rate increased by up to 300% and neonatal mortality rate by 200%.[4]

long term health effects

It is estimated 100,000 to 200,000 people have permanent injuries. Reported symptoms are eye problems, respiratory difficulties, immune and neurological disorders, cardiac failure secondary to lung injury, female reproductive difficulties and birth defects among children born to affected women. [4] The Indian Government and UCC deny permanent injuries were caused by MIC or the other gases.

solutions for the improvement of occupational health in india

According to a scientific paper “strategies and policies deteriorate occupational health situation in india : a review based on social determinant framework” presented by ashish kumar mandal, department of ergonomics, occupational health, kolkata. Following recommendation were pressed forward for the improvement of occupational health in india

improvement of occupational health requires strengthened organization and appropriate leadership in trade unions, concious workers, who are able to control the work process and generation of unbiased information about occupational health risks. Strategies and steps for the improved conditions of occupational health status include

India urgently requires a mordern occupational health safety (OHS) legislation with adequate enforcement, machinery , laws, occupational medicine and a proper awareness programme to catch up with the rest of the world

Health awareness and factors to measure the safety analysis of laborers working in particular industry

Empowering positive trade union so that they can play a key role in demanding occupational health improvements

Making proffesionals available through training and development and enabling them to play an active role in the generation of information and knowledge through proper research.

Work should be given depending upon two principles, which are worker fit for the job and job fit for the worker, so that the employer generates interest on the work avoids lack of attention

Need for policymakers to change their attitude towards occupational health and recognize the occupational health improvement is a vehicle for socio economic development.

Impose a strict vigilance upon hazardous materials by investigators. The government should also weigh the pros and cons between environment and health cost of our people and cost of importing them from elsewhere

Survillance of diseases in industrial belts, maintanance of death certificates, and using record linkage techniques between various resources may also potentially improve the research on occupational health

Quality assurance, crating awareness, accrediation and capacity building, will be needed in the field of occupational health. Model programmes and pilot projects / surveys may be undertaken with the support from ILO/ WHO and different NGO’S like the indian association of occupational health (IAOH) for unorganized sector.